Phone 800-450-7575

Consumer Loan Application

Individual Credit- Relying soley on my income or assets
Joint Credit- We intend to apply for joint credit
Please Initial here
Co-signer Initials here if Joint

IS THIS REQUEST FOR A NEW PURCHASE OR REFINANCING

PURCHASE REFINANCE

Please Provide Auto, Boat, Recreational Vehicle Information

PURCHASE PRICE/PROPERTY VALUE
LOAN AMOUNT

AUTO, BOAT, RV OR SPECIFY OTHER?
YEAR
MAKE
MODEL
VIN/SERIAL #

ARE YOU CURRENTLY WORKING WITH A LOAN OFFICER?	YES NO
LOAN OFFICER NAME	IF APPLICABLE
NORTHVIEW BANK OFFICE LOCATION	OR PREFERED OFFICE LOCATION
REFERRED BY

INFORMATION REGARDING APPLICANT

FIRST NAME		MIDDLE I	LAST
SOCIAL SEC#
DATE OF BIRTH
MARITAL STATUS	MARRIED UNMARRIED SEPARATED
STREET ADDRESS
CITY
STATE
ZIP
EMAIL ADDRESS
PRIMARY PHONE
SECONDARY PHONE
YEARS AT STREET ADDRESS
OWN / RENT	OWN RENT N/A
MONTHLY PYMNT

PREVIOUS ADDRESS ^{If less than 2 years at current}
CITY
STATE
ZIP

EMPLOYER NAME
EMPLOYER ADDRESS
CITY
STATE
ZIP
HOW LONG
AVG MONTHLY INCOME
EMPLOYER PHONE
POSITION/TITLE

PREVIOUS EMPLOYER ^{If less than 2 years at current}
PREVIOUS EMP ADDRESS
CITY
STATE
ZIP
HOW LONG

OTHER SOURCE(S) OF INCOME

Alimony, child support, or seperate maintainence income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

INFORMATION REGARDING JOINT APPLICANT (Complete if applicable)

FIRST NAME		MIDDLE I	LAST
SOCIAL SEC#
DATE OF BIRTH
MARITAL STATUS	MARRIED UNMARRIED SEPERATED
STREET ADDRESS
CITY
STATE
ZIP
EMAIL ADDRESS
PRIMARY PHONE
SECONDARY PHONE
YEARS AT STREET ADDRESS
OWN / RENT	OWN RENT N/A
MONTHLY PYMNT
PREVIOUS ADDRESS ^{If less than 2 years at current}
CITY
STATE
ZIP

EMPLOYER NAME
EMPLOYER ADDRESS
CITY
STATE
ZIP
HOW LONG
AVG MONTHLY INCOME
EMPLOYER PHONE
POSITION/TITLE

PREVIOUS EMPLOYER ^{If less than 2 years at current}
PREVIOUS EMP ADDRESS
CITY
STATE
ZIP
HOW LONG
OTHER SOURCE(S) OF INCOME

Alimony, child support, or seperate maintainence income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

ASSETS AND LIABILITIES

ASSETS

LIABILITIES

		TOTAL AMOUNT($)
CASH / CHECKING / SAVINGS	$
INVESTMENTS	$
RETIREMENT ACCOUNTS	$
HOME	$
OTHER REAL ESTATE TOTAL	$

DEBTS OWED TO		BALANCE		PAYMENT
	$		$
	$		$
	$		$
	$		$
	$		$
	$		$

ARE YOU OBLIGATED TO PAY ALIMONY, CHILD SUPPORT, SEPARATE MAINTENANCE, OR A CONTRACT FOR DEED PAYMENT?

YES NO

IF YES ENTER MONTHLY DOLLAR AMOUNT HERE

I certify that everything I have stated in this application and on any attachments is correct. You may keep this application whether or not it is approved. By signing below I authorize you to check my credit and employment history and to answer questions others may ask you about my credit record with you. I/we agree to provide financial information, upon request, in a form acceptable to you.

APPLICANT FULL NAME		DATE
CO-APPLICANT FULL NAME		DATE